Active NPI
Dare Behavioral Health and Wellness Clinic PLLC
- Psychiatric/Mental Health Nurse Practitioner
- Mesa, AZ
National Provider Identifier
1467341883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- DARE BEHAVIORAL HEALTH AND WELLNESS CLINIC PLLC
- Practice address
- 5235 E Southern Ave Ste 106-145
Mesa, AZ 85206-3626 - Phone
- (480) 501-0511
- NPI assigned
- Jul 1, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Emmanuel Oluwadare
- Title
- Owner
- Phone
- (480) 501-0511
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | Primary |
Addresses
Primary practice location
5235 E Southern Ave Ste 106-145
Mesa, AZ 85206-3626
Mailing address
5235 E Southern Ave Ste 106-145
Mesa, AZ 85206-3626
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
5235 E Southern Ave
Ste 106145
Mesa, AZ 85206
Phone (480) 501-0511
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Phoenix, AZ
- NPI 1902698277
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1751328000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1751328000000",
"number": "1467341883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5235 E SOUTHERN AVE STE 106-145",
"city": "MESA",
"state": "AZ",
"postal_code": "852063626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5235 E SOUTHERN AVE STE 106-145",
"city": "MESA",
"state": "AZ",
"postal_code": "852063626",
"telephone_number": "480-501-0511"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DARE BEHAVIORAL HEALTH AND WELLNESS CLINIC PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-07-01",
"last_updated": "2025-07-01",
"certification_date": "2025-06-30",
"status": "A",
"authorized_official_last_name": "OLUWADARE",
"authorized_official_first_name": "EMMANUEL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "480-501-0511"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.